New Canine/Feline

New Pet Form

Congratulations on your new pet. Please fill in the information so that we can add your pet to our system and create their patient file. Please contact our office at (610) 367-4744 if you have any questions.

Pet's Name*

FirstLast

Sex*

Male

Female

Male Neutered

Female Spayed

Unknown

Birthday or Approximate Age*

Species*

Canine

Feline

Avian

Ferret

Mouse/Rat/Rodent

Reptile/Amphibian

Rabbit

Gerbil/Guine Pig/Hampster

Breed*

Color*

Please list any allergies that your pet has:

What diet are you currently feeding your pet?

Where did you obtain this pet?*

Friend

Breeder

Pet Shop

Humane Society

Other

Photo Authorization Form*

Yes, I authorize Gilbertsville Veterinary Hospital to take and use photos of my pet. I understand that these photos may be used on social media platforms, hospital marketing materials and the Gilbertsville Veterinary Hospital website.

No, I do not authorize Gilbertsville Veterinary Hospital to take or use photos of my pet.

If your pet has a microchip or permanent identification please type their ID for our records.

Please list any alerts that our team should be aware of (examples: needs a muzzle, does not like cats, does not like dogs, etc.)

Has your pet had any prior illness or surgical procedures in the past? Please describe below.

Is your pet currently taking any medication?

Feline Question only: Is your pet declawed? If so, front only or all 4 paws?

Reason for your pet's visit? Please describe below.

Please list any questions or concerns that you have for our veterinarians or team members.

We are AAHA Accredited!

Our Mission

At Gilbertsville Veterinary Hospital, our mission is to celebrate the incredible bond between you and your pet. In order to do that, we offer the highest standards in veterinary medicine, maintain at all times good business practices and provide a sound professionalism in our manner with clients.